去势抵抗性前列腺癌的临床精准治疗进展

The progress of clinical precision medicine in castration-resistant prostate cancer

近年来,我国前列腺癌的发病率呈逐年上升趋势,且大多数患者就诊时癌细胞已经发生转移,内分泌治疗可使多数患者的病情得到控制和改善,但经过一段时间缓解后多数患者极易发展为去势抵抗性前列腺癌(CRPC)。此类患者预后极差,治疗颇为棘手,迫切需要新的治疗策略。精准医学是根据每个患者的个体差异,制定最为合适的个性化治疗方案。基因组、蛋白质组、代谢组等海量生物学数据及大数据分析方法是精准医学模式的精髓。精准医学为人类攻克肿瘤带来了希望。本文就CRPC精准医学的内涵、二代测序及基因组测序在CRPC中的应用及CRPC临床分子靶向治疗的进展进行综述,以总结和探讨CRPC临床精准医学研究的进展。

Most prostate cancer(PCa)patients in China are diagnosed at an advanced stage.Many PCa patients are initially sensitive to hormonal therapy and experience temporary tumor regression,but nearly all of the patients finally reach a state of castration-resistant prostate cancer(CRPC).CRPC is difficult to cure and thus has poor prognosis.The identification of new therapies to treat CRPC remains an urgent need.Precision medicine is to develop the most appropriate individualized treatment for each patient based on the level of individual differences.Genomic,proteomics,metabolomics data,and other big data analysis methods are the essence of precision medicine.Precision medicine brings the hope to overcome cancer.In this review,we summarize the connotation of precision medicine in CRPC,the application of second generation sequencing and genome sequencing,and clinical molecular targeted therapy of CRPC as well as discuss clinical precision medicine for CRPC.